1. Nebraska-Maternal, Infant, Early Childhood Home Visiting (N-MIECHV) Jennifer Auman, Coordinator jennifer.auman@nebraska.gov ; dhhs.ne.gov/HomeVisiting

2. Home Visiting ! Oh sure ! That ’ s where you, uh… visit homes, right?

3. Evidence-Based Home Visiting: What? When? Who? Why? How? Where? So What?

4. Evidence-Based Home Visiting: What it IS:  Family-Centered  Strengths-Based  Relationship-Driven  Culturally Competent  Preventative– looking ahead to the workforce of the future  Voluntary  Free  Empowering– show me HOW What it is NOT:  An Intervention- Do it for them  A sure-fire “Fix” for everyone  “Another handout”  In any way associated with losing or keeping your children (Child Protective Services)

5. Is this “NORMAL???” I can barely support myself; how will I be able to support another person? I heard you can get more benefits if you have a kid. Will I be a good mom?? I don’t know anything about babies! Should I nurse? Drinking just helps me relax. It’s not good for the baby if I’m stressed out. I thought if I got pregnant, he’d stay. That one lady says immunizations will cause my baby to be autistic.

6. From conception to age 3 years, a child has the GREATEST period of development and growth Every experience– BOTH mother and child have shapes the person that child will become; physical, emotional and mental health from the very beginning. Bonding, ENVIRONMENT, NUTRITION — that he or she will have throughout their WHOLE LIFE!

7. WHAT PUTS FAMILIES’ FUTURE HEALTH “ AT RISK?” Teen Pregnancy Depression Mental Illness Poverty or Homelessness Drug or Alcohol Abuse Domestic Violence

8. INCREASES: Appropriate coping skills Pre-Conception and Inter- Conception Planning Quality of Prenatal Care Successful Breastfeeding Well-Child Visits & Proper Immunization Schedules Knowledge of Child Development Physical, Mental and Emotional Health of the Family Effectiveness of Referrals and Coordinate Efforts for the Right Referrals Evidence-Based Home Visiting is a PREVENTATIVE health measure! REDUCES: Child Maltreatment, Abuse, Neglect Domestic Violence Parental Use of Drugs, Alcohol or Tobacco Emergency Room Visits for BOTH Mother and Child Stress

9. Adverse Childhood Experiences or A.C.E.s Divorce Exposure to Alcohol or Drug Abuse Exposure to Domestic Violence Homelessness Poverty Child Maltreatment Parent with Mental Health issues Teen Pregnancy/Teen Parenting Parent who is incarcerated Premature or low birth weight Early Death of a parent or child As the number of ACEs in a person’s life increase, so does the risk of: Obesity Drug, Alcohol or Tobacco Use Diabetes Heart Disease Cancer Child Maltreatment Liver Disease …EVEN Early Death http://www.cdc.gov/violenceprevention/acestudy/ Kaiser Permanente and the Center for Disease Control

10. Perpetuating the cycle— Children live what they’ve learned—it is “hard wired” even if they consciously know the behaviors are negative or risky.

11. The cost of intervention vs PREVENTION of Child Maltreatment; We could pay off the National Debt in less than 10 years.

12. DIRECT COSTS Acute Medical Treatment: $ 2,907,592,094 Mental Health Care: $ 1,153,978,175 Child Welfare System: $29,237,770,193 Law Enforcement: $ 34,279,048 INDIRECT COSTS Special Education: $ 826,174,734 Early Intervention: $ 247,804,537 Emergency/Transitional Housing: $ 1,606,866,538 Mental Health & Health Care (as adults): $ 270,864,199 Juvenile Delinquency: $ 3,416,149,283 Adult Criminal Justice System: $32,724,767,699 Lost Worker Productivity: $ 7,834,164,589 Estimated Cost of Child Maltreatment in the United States per Year TOTAL: $80,260,411,087 Taken from the report prepared by Kathryn Harding, MA, Prevent Child Abuse America. Based on the report by Gelles, J.J. and Perlman, S. (2012). Estimated annual cost of child abuse and neglect. Chicago: Prevent Child Abuse America. Available at: http://www.preventchildabuse.org/downloads/PCAA_Cost_Report_2012_Gelles_Perlman_final.pdf

13. Sounds good, but can you prove it? That’s the Evidence part of “Evidence-Based.”

14. 14 Maternal and Newborn Health Maltreatment, Injury and Emergency Room Visits School Readiness And Achievement Domestic Violence Family Economic Self-Sufficiency Coordination of Referrals And Resources Benchmark Areas

15. With experienced, educated and caring support, We can break the cycles of negative life impact!

16. Legend (DHHS Investments in Home Visiting) Federal MIECHV Formula Grant Federal MIECHV Development Grant State Funds Title V MCH Block Grant N-MIECHV Community Planning completed Previous N-MIECHV investments; currently utilizing local funds Priority Counties Identified through the MIECHV Needs Assessment Process (Handout available)

17. October 30, 2014 Kearney, NE Collaborative Partners: N-MIECHV (NDHHS) Sixpence Early Learning Fund Nebraska Children & Families Foundation Head Start State Collaboration Office Early Development Network Dept. of Education NDHHS Division of Behavioral Health

18. So What?